0001209191-18-038596.txt : 20180619
0001209191-18-038596.hdr.sgml : 20180619
20180619164814
ACCESSION NUMBER: 0001209191-18-038596
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180619
FILED AS OF DATE: 20180619
DATE AS OF CHANGE: 20180619
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: OCLASSEN GLENN A
CENTRAL INDEX KEY: 0001210529
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38529
FILM NUMBER: 18907684
MAIL ADDRESS:
STREET 1: 3290 WEST BAYSHORE RD
CITY: PALO ALTO
STATE: CA
ZIP: 94303
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Verrica Pharmaceuticals Inc.
CENTRAL INDEX KEY: 0001660334
STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834]
IRS NUMBER: 463137900
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 200 GARRETT STREET
CITY: CHARLOTTESVILLE
STATE: VA
ZIP: 22902
BUSINESS PHONE: 434-980-8100
MAIL ADDRESS:
STREET 1: 200 GARRETT STREET
CITY: CHARLOTTESVILLE
STATE: VA
ZIP: 22902
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2018-06-19
0
0001660334
Verrica Pharmaceuticals Inc.
VRCA
0001210529
OCLASSEN GLENN A
C/O VERRICA PHARMACEUTICALS INC.
10 NORTH HIGH STREET, SUITE 200
WEST CHESTER
PA
22902
1
0
0
0
Common Stock
2018-06-19
4
C
0
200734
A
290421
I
See Footnote
Series A Convertible Preferred Stock
2018-06-19
4
C
0
200734
0.00
D
Common Stock
200734
0
I
See Footnote
Each share of Series A Convertible Preferred Stock was convertible at any time at the option of the holder into Common Stock, had no expiration date and converted into shares of Common Stock upon the closing of the Issuer's initial public offering.
The shares are held directly by The Glenn A. Oclassen 2016 Trust dated November 30, 2016 (the "Trust"). The Reporting Person serves as trustee of the Trust.
/s/ Edward Sniezek, Attorney-in-Fact
2018-06-19